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Royce Chen, Pamela Sherwood, Sri Krishna Mukkamala, Frank Siringo, Stanley Chang; Foveal Contour after Pars Plana Vitrectomy for Idiopathic Macular Hole. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2799.
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To evaluate the maximal foveal slope (MFS) after successful primary closure of idiopathic macular hole. To compare the MFS of the operated eye to the fellow, unoperated eye. To assess for correlations between MFS and visual acuity. To analyze the fellow eye for structural changes visible on optical coherence tomography (OCT).
38 eyes of 37 patients with full thickness macular hole (FTMH) undergoing successful pars plana vitrectomy (PPV) and internal limiting membrane (ILM) peeling by a single surgeon were analyzed with spectral domain OCT (SD-OCT). The fellow eyes of surgical cases were examined by SD-OCT for macular pathology. The maximal foveal slope (MFS) was manually measured in each surgical and fellow eye. MFS was studied and compared to visual acuity outcomes.
1 month average MFS was 42 degrees in surgical eyes, and 26 degrees in normal fellow eyes. The average final MFS in all operated eyes was 51 degrees. 82% of patients demonstrated a steeper MFS on the nasal fovea compared to the temporal fovea. There was no correlation between MFS and post-operative best-corrected visual acuity. 49% of patients had a macular abnormality in the fellow eye, most occurring at the vitreoretinal interface.
MFS is generally steepened after FTMH repair, and the nasal foveal slope is typically steeper than the temporal foveal slope. The surgical eye typically has a steeper MFS than the fellow eye, and there is no correlation between MFS and visual acuity. Almost half of fellow eyes have macular abnormalities at the vitreoretinal interface. This finding reinforces the concept that macular holes are not simply an isolated, unilateral process, and fellow eyes should be followed carefully for the risk of macular hole development.
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